Utilization Review Manager

About the role

Lead a centralized virtual utilization management program, keeping clinical and operational standards high while coordinating authorization, denial and appeal work across the organization.

What you will do

• Manage the centralized virtual utilization management program and its support structure
• Oversee authorization, denial and appeal handling for inpatient, observation and outpatient cases
• Own program compliance, development and strategy alongside other authorization managers
• Coordinate with hospital based utilization leaders, physician advisors, coding, care coordination and health information staff
• Provide data and help develop solutions with the wider care team

What they look for

• Skill in gathering and analyzing information to reach timely decisions
• Willingness to raise difficult issues and take bold action
• Ability to persuade others and build commitment to shared outcomes
• Experience coaching and developing people to reach their potential
• Strong emotional intelligence and trust building

Benefits

• Bonus incentives
• Paid certifications
• Tuition reimbursement
• Comprehensive benefits
• Career advancement

Pay

USD 92,400 to 138,600 per year